Hale Goksever Celik, MD

Dr. Goksever Celik is an obstetrician and gynecologist, graduated from the medical school of the Hacettepe University in Ankara, and trained through Obstetrics and Gynecology fellowship at Dokuz Eylul University in Izmir. She has been a postdoctoral research fellow at Molecular Biology and Genetics at Istanbul University. She has been participating in several research especially interested in the association between endometriosis surgery and ovarian reserve and the genetic basis of endometriosis.

How to predict natural conception in women underwent endometriosis surgery?

Endometriosis is defined as the localization of endometrial glandular and stromal cells outside the uterine cavity. The most common symptoms are dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. The prevalence of endometriosis increases in the infertile population. Thus, the important issue for most women is the probability of getting pregnant,  especially following endometriosis surgery. Several classification and scoring systems have been introduced to clinicians’ use, one of the most frequently used is the rAFS score. However, this scoring system cannot be…

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Is Physical Exercise Effective in Endometriosis?

Endometriosis is defined as the localization of endometrial tissue outside the uterine cavity. Dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility are mostly encountered symptoms of endometriosis. Although there are several theories explaining the pathogenesis of endometriosis, the exact pathogenesis still has not been understood. Based on the hypothesis of inflammatory predisposition, the physical activity is thought to have a beneficial effect on endometriosis. Montenegro et al, a group of scientists from Brazil, published an animal study titled as “Effect of Physical…

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Can MRI be used to detect anterior pelvic endometriotic lesions?

Deep infiltrating endometriosis is the most severe manifestation of endometriosis. It is defined as the infiltration of ectopic endometrial tissue under the peritoneum, pelvic structures, and the organ walls such as the uterosacral ligaments, colon, vagina, bladder, ureter, rectovaginal septum, and the lateral parametrium. Only 6% of deep infiltrating endometriosis is located in the anterior compartment of the pelvis including vesicouterine space, the detrusor and the uterus. Although laparoscopy remains the gold standard for diagnosis of anterior pelvic endometriosis, transvaginal…

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Three dimensional sono-vaginography to diagnose rectovaginal endometriosis

Deep infiltrating endometriosis is defined as the localization of ectopic endometrial tissue penetrating more than 5 mm into the affected pelvic organs. Rectovaginal endometriosis is the most severe form of deep infiltrating endometriosis in which ectopic endometrial tissue infiltrating rectum and posterior vaginal fornix extends to the rectovaginal septum, and this form is the most difficult to diagnose. Laparoscopic biopsy and histopathological confirmation are accepted as the gold standard for the diagnosis of endometriosis. However, the structures where the disease…

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Non-assisted reproductive technology treatment: Is it effective in infertile patients with advanced endometriosis?

The marriage and childbearing ages delay due to the life-style changes in developed countries. As a result, advanced age becomes a major concern in infertility treatments which consist of non-ART and ART modalities. Non-ART treatments include mild ovarian stimulation together with timed intercourse and/or intrauterine insemination, whereas ART treatments include in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Isono et al, a group of scientists from Tokyo, published a retrospective study titled as “The efficacy of non-assisted reproductive technology…

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Parametrial endometriosis: A harder form of endometriosis

Deep infiltrating endometriosis is the most severe manifestation of endometriosis, affecting 20% of all patients with endometriosis. It is defined as the infiltration of ectopic endometrial tissue under the peritoneum, pelvic structures, and the organ walls such as the uterosacral ligaments, colon, vagina, bladder, ureter, rectovaginal septum, and the lateral parametrium. Lateral parametrium covers the retroperitoneal connective tissue from the uterus to the lateral pelvic wall. If endometriosis spread to the parametrium, the surgical intervention plays a major role in…

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How to preserve fertility in women with “ovarian endometriosis”?

Although there are many treatment modalities in endometriosis, optimal treatment has not been developed yet. The aim of the treatment is to reduce pain, to preserve and improve fertility and to delay recurrence. Ovarian ischemic and perfusion damage during endometriosis surgery is an important concern to be considered by clinicians. Because ovarian reserve has already decreased due to the presence of endometriosis, surgery should be considered even more carefully. Donnez et al, a group of scientists from Belgium, published a…

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Transvaginal ultrasound for "rectosigmoid endometriosis" diagnosis: Is bowel preparation necessary?

Rectosigmoid endometriosis is a severe form of deep endometriosis. Women having rectosigmoid endometriosis present with pain and several intestinal complains such as constipation, diarrhea, intestinal cramping, abdominal bloating, feeling of incomplete evacuation, the passage of mucus and rectal bleeding during the menstrual period. Transvaginal ultrasound (TVS) is the first line diagnostic method for the detection of rectosigmoid endometriosis. This non-invasive method is also cheaper, easier to tolerate than other methods such as rectal endoscopic sonography, magnetic resonance imaging. Some clinicians…

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Vitamin C supplementation in the patients with endometriosis undergoing in vitro fertilization-embryo transfer

Endometriosis is defined as the localization of endometrial stromal and glandular cells outside the uterine cavity. Women having endometriosis present with dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Thus, infertility remains a significant problem for women with endometriosis. Endometriosis is considered as a complicated chronic inflammatory process associated with an imbalance between oxidative stress and antioxidant response. The role of oxidative stress in the pathogenesis of endometriosis has been the subject of research in recent publications. It has been shown…

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The diagnostic value of “sliding sign” and direct visualization of the bowel in rectal/rectosigmoid deep endometriosis

Deep endometriosis is the presence of endometrial subperitoneal implants of ≥5 mm localized in the rectum/rectosigmoid bowel, uterosacral ligaments, rectovaginal septum, vagina and/or bladder. The most common diagnostic screening methods are the transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) for preoperative screening. The “sliding sign” with TVS has been defined in previous publications, used to determine the obliteration of the pouch of Douglas in women with suspected endometriosis. The visualization of the bowel with TVS to determine the presence of nodules…

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The association between endometriosis, adenomyosis and preterm delivery

Endometriosis and adenomyosis are diseases of the same spectrum which have common features and coexist in some but not all patients. Both diseases are characterized by endometrial implants outside of the uterine cavity. Endometriosis is defined as the localization of endometrium outside the uterus, whereas adenomyosis is recognized by in-growth of the endometrium into the myometrium. The spectrum of symptoms includes dysmenorrhea, chronic pelvic pain, dyspareunia, and infertility. Bruun and Arendt et al, a group of scientists from Aarhus University…

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The comparison of Chinese women in terms of risk factors, genetics and treatment of endometriosis

Endometriosis is characterized by endometrial implants outside of the uterine cavity. There is a wide spectrum of symptoms of this disease including dysmenorrhea, chronic pelvic pain, dyspareunia, extragenital symptoms. The pathogenesis of endometriosis appears to be multifactorial, including ectopic endometrial tissue, altered immunity, imbalanced cell proliferation and apoptosis, aberrant hormonal signaling, and genetic factors. Dai et al, a group of scientists from Peking Union Medical College Hospital in China, published a review titled as “A review of the risk factors,…

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Patient-centered endometriosis care

Endometriosis is defined as endometrial glands and stroma that exist outside the uterine cavity. Ectopic endometrial tissue and resultant inflammation can cause dysmenorrhea, dyspareunia, chronic pain, and infertility, all of which reduce the quality of life. The aim of the management is generally to achieve pain relief which usually is not satisfactory for most patients and unfortunately, the recurrence rate can be as high as 40-50%. However, the goal of the treatment should be to increase the quality of life…

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Stenoses in the colorectal anastomose sites after DIE surgery

Deep infiltrating endometriosis (DIE) is a particular form of endometriosis that penetrates at least 5 mm under the peritoneal surface. DIE is primarily located in the rectosigmoid junction and the rectum with an incidence of 70% and 90%, respectively. The most preferred treatment modality for DIE is laparoscopic resection of colorectal endometriotic nodules. Following this procedure, anastomotic stenosis is a well-recognized complication.  Bertocchi et al, a group of scientists from Sacred-Heart- Don Calabria Hospital in Italy, published an article titled…

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